Flashcards in 1. Introduction to Patients with Diabetes Deck (27)
Approximately how much of the UK NHS budget is spent on diabetes a year?
10% of it, £11 billion.
What is the leading cause of blindness in working age?
How much does type I diabetes reduce life expectancy by?
How much does type II diabetes reduce life expectancy by?
What is diabetes?
Consistently high blood glucose that leads to damage of the small and large blood vessels, causing premature death from cardiovascular diseases.
Describe how the body lowers blood glucose after eating.
Signals sent to the pancreas.
Pancreas releases insulin.
Insulin binds to cell surface receptors so glucose can pass into the cells.
Less glucose is in the blood now.
Which cells release insulin?
Islet cells in the pancreas, B-cells.
What two main reasons causes blood glucose to rise?
Inability to produce insulin due to beta cell failure.
Or adequate insulin production but insulin resistance means it's ineffective (linked to obesity).
What causes type I diabetes?
Autoimmune beta cell destruction, genetically predisposed to it.
What is the clinical presentation of diabetes mellitus?
Symptoms of hyperglycaemia: polyuria, polydipsia, blurring of vision, urogenital infections.
Symptoms of inadequate energy utilisation: tiredness, weakness, lethargy and weight loss (type I).
What causes type II diabetes?
The pancreas doesn't produce enough insulin (deficiency) or there is a resistance to insulin of the cells.
How can diabetes be diagnosed?
Symptoms and one abnormal test or asymptomatic and two abnormal tests from the following:
Fasting glucose levels
Oral glucose tolerance test
What percentage of type I diabetics are diagnosed under the age of 30?
What is the clinical presentation of type I diabetes?
Rapid onset of symptoms: weight loss, polyuria and polydipsia. If left, vomiting and ketoacidosis.
Normally young patient, under 30 years old.
How can type I diabetes be diagnosed?
Elevated venous plasma glucose levels.
Presence of ketones, measured using a 'ketostik'.
How is type I diabetes treated?
With exogenous insulin, given via subcutaneous injections several times a day by pens or pumps.
When was insulin discovered?
What percentage of type II diabetics are overweight?
How can type II diabetes be prevented?
Keep BMI between 20 and 25 kg/m2.
Avoid weight gain over 5kg during adult life.
What are the risk factors of insulin resistance in type II diabetes?
Obesity (85% of risk of developing type II diabetes), muscle and fat deposition, elevated circulating free fatty acids, physical inactivity and genetic influences.
What are the symptoms in type II diabetes?
May be asymptomatic, no urinary ketones.
May have polyuria, polydipsia or weight loss.
What happens if type II diabetes is left untreated?
Become more badly hyperglycaemic, inadequate energy utilisation, worsening of complication of the disease (to do with damage to vessels).
How is type II diabetes managed?
Lifestyle factors, non insulin therapies (metformin, sulphonylureas etc.) or insulin.
What are some acute complications of diabetes?
Hyperglycaemia: ketoacidosis in type I patients, hyperosmolar non-ketotic syndrome (very raised blood glucose but no ketones) in type II patients.
What are some chronic complications of diabetes?
Macrovascular disease: stroke, heart attack, intermittent claudication (not enough blood to lungs) and gangrene.
Micro vascular disease: retinopathy, nephropathy and neuropathy.
What can neuropathy lead to?
Ulcers, a wound is not felt and is unnoticed so can get infected and lead to an ulcer.